Provider Demographics
NPI:1811222425
Name:DUNN, GRACIELA REZA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GRACIELA
Middle Name:REZA
Last Name:DUNN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SANDALWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-7952
Mailing Address - Country:US
Mailing Address - Phone:760-295-7487
Mailing Address - Fax:
Practice Address - Street 1:4701 SANDALWOOD WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-7952
Practice Address - Country:US
Practice Address - Phone:760-295-7487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 223671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical